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1.
Quant Imaging Med Surg ; 14(3): 2528-2538, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38545069

RESUMEN

Background: The hand skeletal features of children and adolescents at different growth statuses and development periods, and the correlation between these skeletal features and hand asymmetric force are currently unclear. Thus, this study sought to investigate the hand skeletal features of children and adolescents at different growth statuses and at different periods of development, and the correlation between these skeletal features and asymmetric force in hands. Methods: A retrospective study was performed on subjects aged 4-20 years with good growth status (group A) or short stature (group B). Additional subjects aged 4-20, 21-40, and >40 years were enrolled in groups C, D, and E, respectively. All the subjects underwent left-hand posteroanterior X-ray radiography. Brachymesophalangia-V (BMP-V), conical epiphysis, epiphysis/metaphysis symmetry of the proximal phalanx (ESP), and the angle of the metacarpal-phalangeal axis were analyzed. Results: Of the 654 children and teenagers aged 4-20 years (median: 11 years) enrolled in the study, 432 were allocated to group A, of whom 237 (54.9%) were male and 195 (45.1%) were female, and 222 matched cases were allocated to group B, of whom 112 (50.5%) were male and 110 (49.5%) were female. The first to third ESPs were significantly (P<0.05) greater in group A than in group B, while the first to third angles of the metacarpal-phalangeal axis were significantly (P<0.05) smaller in group A than in group B. The correlation analysis revealed a highly significant (P<0.01) negative correlation between the ESP and angle of the metacarpal-phalangeal axis (r=-0.948, -0.926, -0.940, -0.885, and -0.848, respectively). The incidence of BMP-V was 15.4% in all patients, while that of conical epiphysis was 19.5%. The incidence of BMP-V and conical epiphysis was significantly (P<0.05) smaller in group A than in group B (11.1% vs. 23.8% for BMP-V and 16.6% vs. 25.2% for conical epiphysis, respectively). Additionally, 216 subjects were enrolled in group C (108 male and 108 female), 185 subjects were enrolled in in group D (93 male and 92 female), and 176 subjects were enrolled in in group E (104 male and 72 female). The second to fifth ESPs in group C were significantly (P<0.05) smaller than those in both groups D and E, while the second to fifth angles of the metacarpal-phalangeal axis were significantly (P<0.05) larger in group C than in both groups D and E. A BMP-V was present in 35 (16.2%) patients in group C, 8 (4.3%) in group D, and 2 (1.1%) in group E, and the difference among the three groups was statistically significant (P<0.05). Conclusions: The epiphyseal symmetry of the proximal phalanges is poor in short stature children and adolescents, and the angle between the metacarpal and phalangeal axes is larger in children and adolescents with short stature than those with normal height and good growth status. A negative correlation was found between the epiphyseal symmetry of the proximal phalanges and asymmetrical stress.

2.
Quant Imaging Med Surg ; 13(5): 3266-3278, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-37179940

RESUMEN

Background: To investigate the deformity and asymmetry of the shoulder and pelvis in adolescent idiopathic scoliosis (AIS) patients. Methods: This retrospective cross-sectional study enrolled 223 AIS patients with a right thoracic curve or left thoracolumbar/lumbar curve who underwent spine radiographs at the Third Hospital of Hebei Medical University between November 2020 and December 2021. The following parameters were measured: Cobb angle, clavicular angle, glenoid obliquity angle, acromioclavicular joint deviation, femoral neck-shaft projection angle, iliac obliquity angle, acetabular obliquity angle, coronal trunk deviation distance, and spinal deformity deviation distance. The Mann-Whitney U test, Kruskal-Wallis H test were used for inter-group comparisons, and Wilcoxon signed-rank test were used for intra-group left and right sides comparisons. Results: Shoulder and pelvic imbalances were found in 134 and 120 patients, respectively, and there were 87, 109, and 27 cases of mild, moderate, and severe scoliosis, respectively. Compared with mild scoliosis patients, the difference in the acromioclavicular joint offset on bilateral sides was significantly increased in moderate and severe scoliosis [11.04, 95% confidence interval (CI): 0.09-0.14 for mild, 0.13-0.17 for moderate, and 0.15-0.27 for severe scoliosis, P=0.004], and the difference in the femoral neck-shaft projection angle on bilateral sides was significantly enhanced with scoliosis aggravation (14.14, 95% CI: 2.34-3.41 for mild, 3.00-3.94 for moderate, and 3.57-6.43 for severe scoliosis, P=0.001). The acromioclavicular joint offset was significantly larger on the left than that on the right in patients with a thoracic curve or double curves (thoracic curve -2.75, 95% CI: 0.57-0.69 for the left and 0.50-0.63 for the right, P=0.006; double curve -3.27, 95% CI: 0.60-0.77 for the left and 0.48-0.65 for the right, P=0.001). The femoral neck-shaft projection angle was significantly larger on the left than right in patients with a thoracic curve (-4.46, 95% CI: 133.78-136.20 for the left and 131.62-134.01 for the right, P<0.001), but larger on the right than left in patients with thoracolumbar/lumbar curve (thoracolumbar -2.98, 95% CI: 133.75-136.70 for the left and 135.13-137.82 for the right, P=0.003; lumbar -3.24, 131.97-134.56 for the left and 133.76-136.26 for the right, P=0.001). Conclusions: In AIS patients, shoulder imbalance has a greater impact on coronal balance and spinal scoliosis above the lumbar segment, whereas pelvic imbalance has a greater impact on sagittal balance and spinal scoliosis below the thoracic segment.

3.
Front Pediatr ; 10: 979816, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36340704

RESUMEN

Background: The relationship of trunk balance with head posture and plantar pressure is unknown in patients with adolescent idiopathic scoliosis (AIS). Objective: To investigate the relationship of trunk balance with head posture and plantar pressure by analyzing the imaging data of patients with AIS. Materials and methods: This retrospective study was performed on 80 AIS patients who had whole spine frontal and lateral radiographs, and the imaging parameters were measured and analyzed. Results: The coronal trunk imbalance rate was 67.5%, the trunk offset direction was towards left in 65 cases and right in 15 cases, and the head offset direction was towards left in 66 cases and right in 14 cases. The sagittal trunk imbalance rate was 57.25%. The distance of apical vertebrae and head offset in the coronal trunk balance group was significantly (P < 0.05) smaller than that in the imbalance group. The apical vertebrae offset distance and head offset distance were positively correlated with the tilt angle of trunk (r = 0.484 and 0.642, respectively, P < 0.05). The difference in the percentage of pressure load on the left and right foot was significantly (P < 0.05) greater in the coronal imbalance group than that in the balance group.The center of pressure (COP) sway area was significantly (P < 0.05) larger in the overall trunk imbalance group (both coronal and sagittal imbalance) than in the balanced group. Conclusion: Most AIS patients have trunk imbalance which is severer on the coronal than on the sagittal plane. AIS patients with trunk imbalance show more significant local deformities, greater head offset, greater COP sway area, and decreased head and standing stability.

4.
Quant Imaging Med Surg ; 12(6): 3049-3060, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35655841

RESUMEN

Background: To investigate the relationship between sagittal alignment and coronal deformity in patients with adolescent idiopathic scoliosis (AIS) through analysis of the spinal imaging data. Methods: Four hundred and fifty-four AIS patients who underwent anteroposterior and lateral radiography of the while spine were enrolled, and the spinal parameters of Cobb angle, cervical lordosis, C1-C2 angle, T1 slope, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt (PT), pelvic incidence (PI), cervical sagittal vertical axis (SVA), and spinal SVA were analyzed. Results: The patients were divided into two groups according to the size of the Cobb angle: group A (Cobb angle ≤45°, n=414) and group B (Cobb angle >45°, n=40). In group A, the Cobb angle was in a medium negative correlation with the cervical lordosis angle (r=-0.637, P<0.001), a weak positive correlation (|r|<0.3, P<0.05) with C1-C2 angle, T1 slope and thoracic kyphosis. In group B, the Cobb angle was in a mild positive correlation (P<0.05) with PT (r=0.398) and PI (r=0.360). The cervical lordosis angle was significantly (P<0.05) different between male and female patients in both groups. In Group A, the cervical lordosis angle was in a significantly (P<0.01) positive correlation with the T1 slope (r=0.586), thoracic kyphosis (r=0.490), and sagittal vertical axis (r=0.135), and a significantly (P<0.01) negative correlation with cervical sagittal vertical axis (r=-0.128) and C1-C2 angle (r=-0.155). In group B, the cervical lordosis angle was in a significantly (P<0.05) positive correlation with T1 slope (r=0.661), thoracic kyphosis (r=0.608), lumbar lordosis (r=0.425), sacral slope (r=0.434), and sagittal vertical axis (r=0.335). Conclusions: In AIS patients with the Cobb angle ≤45º, a significant negative correlation exists between the cervical lordosis and the Cobb angle. The sagittal morphology of the cervical spine in AIS patients is affected by the spinal coronal deformity, which plays an important role in the treatment of AIS.

5.
Orthop Traumatol Surg Res ; 108(6): 103352, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35714918

RESUMEN

INTRODUCTION: Surgery for patients with adolescent idiopathic scoliosis (AIS) may change spinal sagittal alignment, and postoperative adding-on may affect spinal sagittal balance after reconstruction. This study was to investigate the effect of surgery on spinal sagittal alignment and the relationship between postoperative adding-on and spinal sagittal balance in patients with AIS. HYPOTHESIS: The hypothesis of this study was that the effect of surgery on AIS was associated with recovery of the spinal sagittal plane and that presence of postoperative adding-on might affect the spinal sagittal balance. Materials and methods This retrospective study enrolled 22 patients who received surgical treatment. Clinical, imaging and follow-up data were analyzed. RESULTS: After surgery, T1 slope (T1S) and thoracic kyphosis (TK) were significantly (P<0.05) lower in patients with postoperative adding-on (16.73°±6.12° for T1S and 28.95°±11.3° for TK) than those without adding-on (24.82°±8.59° for T1S and 40.29°±12.08° for TK). At the last follow-up, cervical lordosis (CL), T1S, and TK were significantly (P<0.05) lower in patients with adding-on (3.05°±11.41° for CL, 22.12°±3.68° for T1S, and 37.89°±8.97° for TK) than those without adding-on (15.94°±°13.6 for CL, 28.86°±4.26° for T1S, and 47.64°±7.1° for TK). The Cobb angle was significantly (19.65°±8.69° vs. 50.66°±11.46°; P<0.001) decreased after compared with that before surgery. At the final follow-up, the Cobb angle (26.48°±9.61° vs. 19.65°±8.69°, P<0.001), T1S (24.87°±5.11° vs. 20.04°±8.13°), and TK (41.88°±9.45° vs 33.53°±12.71°) all significantly (P<0.01) increased compared with those immediately after surgery. The Cobb angle significantly (26.48°±9.61° vs. 50.66°±11.46°, P<0.001) decreased while CL, T1S, and TK all significantly (8.32°±13.67° vs 2.47°±14.42° for CL, T1S 24.87°±5.11° vs. 21.28°±5.88° for T1S, and 41.88°±9.45° vs. 33.13°±10.97° for TK, P<0.05) increased at the final follow-up compared with those before surgery. DISCUSSION: Surgery affects spinal sagittal alignment, and postoperative adding-on may affect spinal sagittal balance after reconstruction. Surgery as the ultimate approach for AIS has good effects but may result in some side effects. LEVEL OF PROOF: III, retrospective cohort study.


Asunto(s)
Cifosis , Lordosis , Escoliosis , Fusión Vertebral , Adolescente , Vértebras Cervicales/cirugía , Humanos , Cifosis/diagnóstico por imagen , Cifosis/cirugía , Lordosis/diagnóstico por imagen , Lordosis/cirugía , Estudios Retrospectivos , Escoliosis/diagnóstico por imagen , Escoliosis/cirugía , Fusión Vertebral/métodos , Vértebras Torácicas/diagnóstico por imagen , Vértebras Torácicas/cirugía
6.
Curr Med Imaging ; 18(10): 1093-1098, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35410618

RESUMEN

OBJECTIVE: The objective of this study is to analyze the clinical and imaging features of desmoplastic fibroma of bone (DFB) for correct diagnosis. MATERIALS AND METHODS: Twenty patients with DFB confirmed by pathology were enrolled, and the imaging presentations were analyzed. Among 20 patients, plain X-ray was performed in all patients, computed tomography (CT) was performed in 12, and magnetic resonance imaging (MRI) was conducted on eight. The clinical and imaging presentations were analyzed and classified to assist in correct diagnosis. RESULTS: Twenty patients with DFB were retrieved, including eleven males and nine females with an age range of 2-52 years (median 27). The DFB involved the femur in six patients, ilium in five, tibia in four, humerus in two, lumbar vertebra in one, radius in one, and calcaneus in the remaining one. DFB was common in the metaphysis of long bones and could involve the diaphysis and epiphysis. The imaging presentations were divided into four types: the cystic expansile destruction in ten patients, osteolytic destruction in five, mixed destruction in four, and paraosseous destruction in one. CT value was 30 -60 Hu in the lesion area (6 cases CT value45Hu). In eight patients with MRI scanning, the lesion in five patients presented with unevenly equal or low signal on T1WI and unevenly equal or high signal on T2WI, with irregular stripes or patches of low signal on both T1WI and T2WI. In the rest three patients, the lesion was evenly equal or low signal on T1WI and evenly high signal on T2WI. MRI more clearly showed a mass in the adjacent soft tissue and the range of edema in the DFB lesion. CONCLUSION: DFB is a rare tumor with strong local aggressiveness, cystic bone destruction, formation of tumor bone trabeculae, soft tissue masses on imaging presentations, low signals on T1WI and T2WI in the lesion, but no periosteal reaction or calcification, which are helpful for diagnosis of the disease and differentiation from other ones.


Asunto(s)
Neoplasias Óseas , Fibroma Desmoplásico , Adolescente , Adulto , Neoplasias Óseas/diagnóstico por imagen , Niño , Preescolar , Femenino , Fibroma Desmoplásico/diagnóstico por imagen , Fibroma Desmoplásico/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tibia/diagnóstico por imagen , Tibia/patología , Tomografía Computarizada por Rayos X , Adulto Joven
7.
Curr Med Imaging ; 18(3): 322-326, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34279207

RESUMEN

BACKGROUND: The clinical and imaging features of lower tibial shaft spiral fracture concurrent with distal tibial triplane fracture are not clear. INTRODUCTION: This study was conducted to investigate these features for correct diagnosis, treatment and prevention of possible premature physeal arrest or angular deformation. METHODS: Patients with lower tibial shaft spiral fracture concurrent with distal tibial triplane fracture were enrolled, and the clinical, imaging, treatment and follow-up data were analyzed. RESULTS: Five patients with lower tibial shaft spiral fracture concurrent with distal tibial triplane fracture were found including four men and one woman with an age range of 12-15 years (mean 13.6). Injury to the distal tibial epiphysis was missed in the diagnosis in plain radiography reports, but careful reevaluation confirmed distal tibial epiphysis fracture in four cases including Salter-Harris type II in three cases and type III in one case. The remaining case had no apparent distal tibial epiphysis injury in the plain radiograph. CT scan revealed that all five patients had distal tibial triplane fracture of the lateral type including two fragments in three cases and three fragments in two cases. The fracture was divided into type I(within the articular weight-bearing line) in three cases, type II (outside the articular weight-bearing line) in two cases based on the involvement of the articular surface by the fracture line. For the lower tibial fracture, one patient was treated with closed reduction and fixation with an elastic nail, three patients had internal plate fixation, and the remaining patient had cast immobilization. Followed up for 3-11 months (mean 7), all the distal tibial fractures and the triplane fractures were healed without varus or valgus deformity in the ankle. CONCLUSION: Distal tibial triplane fracture can be readily missed in plain radiography and should be suspected in patients with distal tibial spiral fracture which should be evaluated with a computed tomographic scan.


Asunto(s)
Fracturas de la Tibia , Adolescente , Niño , Femenino , Fijación Interna de Fracturas , Humanos , Masculino , Radiografía , Fracturas de la Tibia/complicaciones , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/cirugía , Tomografía Computarizada por Rayos X/métodos
8.
Injury ; 53(3): 1049-1056, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34809925

RESUMEN

OBJECTIVES: To investigate the value of 45° reverse oblique view of the carpal palm in diagnosing scaphoid waist fracture and displacement. METHODS: Eighty-four patients with wrist injury and plain radiography including posteroanterior, lateral, Stecher, and 45° reverse oblique view of the wrist were analyzed for the detection rate in diagnosing scaphoid fractures and displacement. The degree of difficulty in the four views for detecting the scaphoid waist fracture and displacement was rated on a five-grade Likert scale. RESULTS: Among 84 patients, scaphoid waist fractures occurred in 43, and fracture displacement in 32. A significantly (P<0.01) greater rate of detecting the scaphoid waist fracture was found in the Stecher, and 45° reverse oblique view than in the posteroanterior and lateral views. The rate of detecting fracture displacement was significantly (P<0.01) greater in the Stecher and 45° reverse oblique view than in the posteroanterior and lateral views. The Stecher view had a significantly (P = 0.006) lower rate of detecting fracture displacement than the 45° reverse oblique view. It was significantly (P<0.001) easier to identify the scaphoid waist fracture and displacement with the 45° reverse oblique view and the Stecher view than with the posteroanterior and lateral view. The 45° reverse oblique view had the easiest degree to identify the scaphoid waist fracture displacement, followed by the Stecher view, the posteroanterior and the lateral view (P<0.001). CONCLUSIONS: The 45° reverse oblique view clearly shows the scaphoid oblique view in the long axis for better observation of the scaphoid waist fracture and displacement.


Asunto(s)
Fracturas Óseas , Hueso Escafoides , Traumatismos de la Muñeca , Fracturas Óseas/diagnóstico por imagen , Humanos , Radiografía , Hueso Escafoides/diagnóstico por imagen , Hueso Escafoides/lesiones , Traumatismos de la Muñeca/diagnóstico por imagen , Articulación de la Muñeca
9.
Sci Rep ; 11(1): 1589, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-33452403

RESUMEN

This study was performed to propose a method, the Feature Ambiguity Mitigate Operator (FAMO) model, to mitigate feature ambiguity in bone fracture detection on radiographs of various body parts. A total of 9040 radiographic studies were extracted. These images were classified into several body part types including 1651 hand, 1302 wrist, 406 elbow, 696 shoulder, 1580 pelvic, 948 knee, 1180 ankle, and 1277 foot images. Instance segmentation was annotated by radiologists. The ResNext-101+FPN was employed as the baseline network structure and the FAMO model for processing. The proposed FAMO model and other ablative models were tested on a test set of 20% total radiographs in a balanced body part distribution. To the per-fracture extent, an AP (average precision) analysis was performed. For per-image and per-case, the sensitivity, specificity, and AUC (area under the receiver operating characteristic curve) were analyzed. At the per-fracture level, the controlled experiment set the baseline AP to 76.8% (95% CI: 76.1%, 77.4%), and the major experiment using FAMO as a preprocessor improved the AP to 77.4% (95% CI: 76.6%, 78.2%). At the per-image level, the sensitivity, specificity, and AUC were 61.9% (95% CI: 58.7%, 65.0%), 91.5% (95% CI: 89.5%, 93.3%), and 74.9% (95% CI: 74.1%, 75.7%), respectively, for the controlled experiment, and 64.5% (95% CI: 61.3%, 67.5%), 92.9% (95% CI: 91.0%, 94.5%), and 77.5% (95% CI: 76.5%, 78.5%), respectively, for the experiment with FAMO. At the per-case level, the sensitivity, specificity, and AUC were 74.9% (95% CI: 70.6%, 78.7%), 91.7%% (95% CI: 88.8%, 93.9%), and 85.7% (95% CI: 84.8%, 86.5%), respectively, for the controlled experiment, and 77.5% (95% CI: 73.3%, 81.1%), 93.4% (95% CI: 90.7%, 95.4%), and 86.5% (95% CI: 85.6%, 87.4%), respectively, for the experiment with FAMO. In conclusion, in bone fracture detection, FAMO is an effective preprocessor to enhance model performance by mitigating feature ambiguity in the network.


Asunto(s)
Fracturas Óseas/diagnóstico por imagen , Redes Neurales de la Computación , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Área Bajo la Curva , Codo/diagnóstico por imagen , Humanos , Curva ROC , Hombro/diagnóstico por imagen , Muñeca/diagnóstico por imagen , Rayos X
10.
BMC Musculoskelet Disord ; 22(1): 27, 2021 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-33407312

RESUMEN

BACKGROUND: To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis. METHODS: Twenty-four patients with long bone hemangiomas confirmed by pathology were enrolled. Nineteen patients had plain radiography, fourteen patients had computed tomography (CT) and eleven had magnetic resonance imaging (MRI). The hemangioma was divided into medullary [13], periosteal [6] and intracortical type [5]. RESULTS: Among 19 patients with plain radiography, eleven patients were medullary, three periosteal, and five intracortical. In the medullary type, the lesion was primarily osteolytic, including five cases with irregular and unclear rims and one lesion having osteosclerotic and unclear rims. In three patients with the periosteal type, the lesion had clear rims with involvement of the cortical bone in the form of bone defect, including two cases with local thickened bone periosteum and one case having expansile periosteum. Five intracortical hemangiomas had intracortical osteolytic lesions with clear margins. Among 14 patients with CT imaging, 8 cases were medullary, three periosteal, and three intracortical. Among 8 medullary hemangiomas, one had ground glass opacity, and seven had osteolytic, expansile lesions like soft tissue density with no calcification. In three periosteal cases, the lesion was osteolytic with thickened periosteum and narrowed medullary cavity. In three intracortical hemangiomas, the lesion was of even soft tissue density with no calcification. Among 11 patients with MRI imaging, seven were medullary, two periosteal, and two intracortical. Among 7 medullary lesions, six were of hypointense signal on T1WI and hyperintensesignal on T2 WI. In two periosteal cases, the periosteum was thickened, with one case being of equal signal, and the other having no signal. Two intracortical hemangiomas were both of slightly low signal on T1WI but hyperintense signal on T2WI. CONCLUSIONS: The long bone hemangiomas had characteristic cystic honeycomb-like presentations in plain radiograph. CT and MRI imagings are helpful for diagnosis of hemangiomas in long bone.


Asunto(s)
Neoplasias Óseas , Hemangioma , Neoplasias Óseas/diagnóstico por imagen , Hemangioma/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Radiografía , Tomografía Computarizada por Rayos X
11.
Sci Rep ; 10(1): 13502, 2020 08 11.
Artículo en Inglés | MEDLINE | ID: mdl-32782274

RESUMEN

To investigate the value of modified calcaneal axial radiograph-the horizontal calcaneal axial radiograph in diagnosing calcaneal fractures, patients who had acute calcaneal fractures or internal fixation were enrolled, and three groups were established, including the acute fracture group (n = 20), the internal fixation group (n = 20), and the healthy control group (n = 20). All the subjects had regular and modified calcaneal axial radiograph for comparison. In analysis of the results, all volunteers could have ankle dorsiflexion at different degrees. When the ankle was at 30º dorsiflexion for regular axial radiograph, the subtalar joint and the sustentaculum tali could not be clearly displayed. The calcaneus was elongated if the tube tilted in a larger angle but shortened if the tube titled in a smaller angle. When the ankle was at neutral (0º dorsiflexion) location with the tube tilting 45° cephalad or when the ankle was at 20° plantarflexion with the tube tilting 35° cephalad, the subtalar joint, sustentaculum tali, calcaneal body and internal and external calcaneal processes could all be clearly demonstrated. No significant difference (P = 0.79) existed in displaying the bony anatomical structures in regular compared with modified calcaneal axial radiography. For patients with acute calcaneal factures or with internal fixation, the modified calcaneal axial radiography could display more significantly clearly (P = 0.001) bony anatomical structures than the regular one. In conclusion, the modified calcaneal axial radiograph can be performed easily and can clearly show the bony structure of the calcaneus and surrounding bones without adding pain to the patients with calcaneal fractures.


Asunto(s)
Calcáneo/lesiones , Fracturas Óseas/diagnóstico por imagen , Radiografía , Adulto , Calcáneo/diagnóstico por imagen , Femenino , Humanos , Masculino
12.
Sci Rep ; 10(1): 4001, 2020 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-32132591

RESUMEN

To investigate the characteristics of imaging changes with time of facial fractures, patients with facial fractures who had computed tomographic scan were enrolled including 500 patients who were divided into six groups based on the time of scanning: super early (<3 d), early (4-7 d), early-to-medium (8-14 d), medium (15-21d), medium-to-late (22d-2 months) and late stage (>2 months). The data were compared and analyzed. Forty two patients with frontal bone fractures had high-energy impact as the reason of fractures. The fracture line was clear and sharp within one week but blunt and sclerotic due to bone absorption at 2-3 weeks, and might exist for a long time. All patients had soft tissue swelling and paranasal sinus effusion at 1-2 weeks after injury. Air might gather in the adjacent soft tissues and/or intracranially within 3 days of injury if the fracture involved the frontal or other sinuses. Twelve of the 42 patients (28.6%) had intracranial hematoma, and five (11.9%) had epidural effusion. Subarachnoid hemorrhage was mostly absorbed within one week while epidural hematoma was completely absorbed over 3 weeks. Significant changes (P < 0.05) in the fracture lines, effusion of paranasal sinuses, soft tissue swelling and pneumocephalus were observed during the study period. For patients with medial orbital wall fractures, the fracture line was sharp and clear at early stages with concurrent sphenoid sinus effusion, and the fracture line became depressed 3 weeks later with disappearance of sphenoid sinus effusion. Significant changes (P < 0.05) were observed in the sharp fracture line, soft tissue swelling, sphenoid sinus effusion and smooth depression at fracture sites. For nasal fractures, the fracture line was sharp and clear at early stages with concurrent soft tissue swelling which disappeared one week later. The fracture line became smooth three weeks later. A significant (P < 0.05) difference was demonstrated in the changes of fracture line and soft tissue swelling with time. In conclusion, facial fractures have some dynamic alterations with time and identification of these characteristics may help reaching a correct clinical diagnosis with regard to fracture severity and time.


Asunto(s)
Huesos Faciales , Fracturas Craneales , Adolescente , Adulto , Anciano , Niño , Preescolar , Huesos Faciales/lesiones , Huesos Faciales/metabolismo , Huesos Faciales/patología , Huesos Faciales/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fracturas Craneales/metabolismo , Fracturas Craneales/patología , Fracturas Craneales/fisiopatología , Factores de Tiempo
13.
Arch Osteoporos ; 15(1): 18, 2020 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-32088768

RESUMEN

We found that the MRI T2* value is moderately negatively correlated with the bone mineral density assessed with quantitative computed tomography in evaluating osteoporosis in postmenopausal women and may have some potential in assessing severity of lumbar osteoporosis for scientific research. PURPOSE: To investigate the T2* quantitative measurement in magnetic resonance imaging (MRI) and its correlation with the bone mineral density (BMD) values evaluated with quantitative computed tomography (QCT) in women with postmenopausal lumbar vertebrae osteoporosis. MATERIALS AND METHODS: Eighty-seven postmenopausal women were enrolled who had MRI scanning with T1WI, T2WI, and T2* mapping sequences and QCT evaluation of BMD. The T2* value and the BMD were assessed in lumbar vertebral bodies 2-4. Based on the BMD values, the patients were divided into three groups: normal, osteopenia, and osteoporosis. RESULTS: The inter- and intra-observer intraclass correlation coefficients (ICCs) for T2* were 0.91 (0.87-0.94, 95% CI) and 0.93 (0.88-0.95, 95% CI), respectively. The inter- and intra-observer ICCs for the BMD value were 0.89 (0.83-0.92, 95% CI) and 0.91 (0.86-0.93, 95% CI), respectively. The differences of the T2* values and BMD among the three groups were statistically significant (P < 0.05). The BMD value was greater in the normal group (145.02 ± 18.94 mg/cm3) than the other two groups (97.90 ± 16.18 mg/cm3 for osteopenia and 59.09 ± 18.71 mg/cm3 for osteoporosis). The normal group had a significantly (P < 0.05) smaller T2* value than the other two groups (8.39 ± 4.17 ms in the normal group versus 12.25 ± 3.36 ms in the osteopenia or 15.54 ± 4.9 ms in the osteoporosis). A significant (P < 0.05) difference also existed in the T2* value between the osteopenia and the osteoporosis groups. The correlations of the T2* values with BMD values were significantly (P < 0.05) negative after adjusting for age (r = - 0.33, - 0.45, and - 0.51 for normal, osteopenia, and osteoporosis, respectively). CONCLUSION: The MRI T2*value is moderately negatively correlated with the bone mineral density assessed with quantitative computed tomography in evaluating osteoporosis in postmenopausal women and may have some potential in assessing severity of lumbar osteoporosis for scientific research.


Asunto(s)
Densidad Ósea , Imagen por Resonancia Magnética/estadística & datos numéricos , Osteoporosis Posmenopáusica/diagnóstico por imagen , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Anciano , Femenino , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/fisiopatología , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X/métodos
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